Gender and self-rated mental health: an integrative approach

Men often self-rate their mental health better than women and other gender groups. To better assess how gender is related to self-rated health, this study goes beyond the binary approach and explores how variations in self-rated mental health across multiple fixed gender categories are associated with variations along the continuous masculinity and femininity scales.

Data came from a large sample of Canadian adults (n = 11,712) collected from August 17 to September 19, 2021. Gender identity is measured using both fixed categories (i.e., men, women, and TNO-trans, non-binary, or other genders) as well as self-ratings of masculinity and femininity on a scale from 0 to 100. Self-rated mental health includes four categories: poor, fair, good, and excellent. Logistic regression models were used in estimations.

Men reported better self-rated mental health than women and individuals who identify as trans, non-binary, or other genders. These gender gaps become non-significant once femininity and masculinity scales are taken into account. Overall, both femininity and masculinity are positively and non-linearly associated with self-rated mental health, and the positive associations get stronger at higher levels of femininity and masculinity. When separated by fixed gender categories, the accelerating positive effect of masculinity on self-rated mental health is present among both men and women, but not among TNO individuals. In contrast, the accelerating positive effect of femininity is observed only among men.

The gender gaps in self-rated mental health are primarily driven by the differing relationships between mental health and masculinity and femininity across gender categories. Improvement in measuring gender identity can provide valuable insights into how gender is a critical determinant of mental health and mental health disparities. It can also help identify those most affected and enable more targeted prevention and treatment services.